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Regional Meeting on Zoonotic Diseases Regional Meeting on Zoonotic Diseases A Report of the Meeting Jakarta, Indonesia, 6-8 November 2007 SEA-CD-174 Distribution: General Regional Meeting on Zoonotic Diseases Report of the Meeting Jakarta, Indonesia, 6–8 November 2007 Regional Office for South-East Asia © World Health Organization This document is not a formal publication of the World Health Organization (WHO), and all rights are reserved by the Organization. The document may, however, be freely reviewed, abstracted, reproduced or translated, in part or in whole, but not for sale or for use in conjunction with commercial purposes. The views expressed in documents by named authors are solely the responsibility of those authors. New Delhi, April 2008 Contents Page Acronyms used .......................................................................................................v Executive summary................................................................................................vii Agenda I: Inaugural session.................................................................................... 1 Agenda II: Business session .................................................................................... 3 Agenda III: Zoonoses situation ............................................................................... 4 Agenda IV: Partnerships for zoonoses control....................................................... 10 Agenda V: Policy document ................................................................................ 15 Agenda VI: Group works ..................................................................................... 18 Agenda VII: International partners’ meeting (parallel meeting) ............................ 19 Agenda VIII: Presentation of group work.............................................................. 20 Agenda IX: Conclusions and recommendations.................................................... 25 Agenda X: Closing session................................................................................... 26 Annexes 1. Programme ................................................................................................. 27 2. List of participants ....................................................................................... 30 Page iii Acronyms used ADB Asian Development Bank AHI avian and human influenza AI avian influenza AIDS Acquired Immunodeficiency Syndrome APSED Asia-Pacific Strategy for Emerging Diseases ASEAN Association of South-East Asian Nations AusAID Australian Agency for International Development BSE Bovine Spongiform Encephalopathy CAREID Canada Asia Regional Emerging Infectious Disease Project CDC Centres for Disease Control CIDA Canadian International Development Agency CSR Communicable Diseases Surveillance and Response DALYs disability-adjusted life years EID emerging infectious diseases EC European Commission FAO Food and Agriculture Organization of the United Nations FETP Field Epidemiology Training Programme GDD Global Disease Detection GF-TAD Global Framework for Progressive Control of Transboundary Animal Diseases GLEWS Global Early Warning System GOARN Global Outbreak Alert and Response Network HIV human immunodeficiency virus HPAI highly pathogenic avian influenza HQ headquarters IHR International Health Regulations INFOSAN International Network of Food Safety Authorities JE Japanese encephalitis Page v Acronyms used JICA Japan International Cooperation Agency M&E monitoring and evaluation MBDS Mekong Basin Disease Surveillance NICD National Institute of Communicable Diseases NGO nongovernmental organization nvCJD new variant Creutzfeldt-Jacob disease OIE Office Internationale des Epizooties PHAC Public Health Agency of Canada PHEIC public health emergency of international concern RC Regional Committee RO Regional Office SAARC South-Asian Association for Regional Cooperation SARS Severe Acute Respiratory Syndrome SEARO Regional Office for South-East Asia (WHO) SPS sanitary and phytosanitary measures TADs transboundary animal diseases UN United Nations UNEP United Nations Environment Programme UNHABITAT The United Nations Human Settlements Programme UNICEF United Nations Children’s Fund UK United Kingdom USAID United States Agency for International Development UNSIC United Nations System Influenza Coordination VPH veterinary public health WAHIS World Animal Health Information System WHO World Health Organization WPRO WHO Regional Office for the Western Pacific WTO World Trade Organization Page vi Executive summary The Regional Meeting on Zoonotic Diseases was held by the World Health Organization’s (WHO) Regional Office for South-East Asia (SEARO) in coordination with the Government of Indonesia in Jakarta from 6-8 November 2007. The programme schedule is presented in Annex 1 and the list of participants is detailed in Annex 2. To start the opening session, participants and observers were welcomed by the Ministry of Health of Indonesia. The increasing importance of veterinary public health (VPH) was highlighted by the delegates of the Indonesia Country office of the Food and Agriculture Organization of the United Nations (FAO). The Regional Representative of Office Internationale des Epizooties (OIE) for Asia and the Pacific stressed the importance of zoonoses prevention and control in the context of globalization of international trade, changes in agricultural practices and global warming, and highlighted the importance of international partnerships in addressing these issues. The Director of Programme Management of WHO’s South-East Asia Region delivered a message from the Regional Director, Dr Samlee Plianbangchang. The recent outbreaks of Severe Acute Respiratory Syndrome (SARS), avian influenza and the Nipah virus in countries of South-East Asia Region have clearly demonstrated the vulnerability of our countries to emerging and re-emerging infectious diseases. Whatever the structure of veterinary public health services within the country, it is important to ensure that effective functioning systems are established for early detection and response to zoonotic diseases. The overall objective of the meeting is to discuss and arrive at a consensus on a regional strategic framework for prevention and control of zoonoses and to identify mechanisms for its implementation at the regional and country levels. WHO will work closely with FAO, OIE, the ministries of health and other relevant ministries and stakeholders of Member countries to achieve the common goal of zoonoses prevention, control and containment. An inaugural address was delivered on behalf of Health Minister of the Government of Indonesia. Considering the importance of zoonotic diseases in Indonesia, it was hoped that this meeting will be productive and produce concrete and practical recommendations for the prevention and control of zoonotic diseases in the South-East Asia (SEA) Region. The business session commenced with an outline of the objectives of the meeting, introduction of the participants, observers and WHO Page vii Executive summary Secretariat for the meeting and the nomination of a Chairperson, Vice- Chairperson and rapporteurs. In the first session, a presentation was made on ecology and zoonoses. Global warming, climate change and extreme weather conditions all have an adverse effect on biodiversity, distribution of animals and microflora, which can lead to the emergence of zoonotic agents and create favourable conditions for disease outbreaks. A centre for the strategic control and prevention of zoonotic diseases with multisectoral involvement and collaboration is needed. The next presentation outlined the global scenario, burden and importance of zoonoses and depicted the pattern of emerging zoonoses over the period 1996-2007. It has been demonstrated that a disproportionate share of the burden of zoonosis is borne by the poor. There is a need to accelerate regional and national capacity building for integrated zoonoses detection and control through effective intersectoral collaboration at the level of the human/animal health interface. A presentation on International Health Regulations (2005) in the context of emerging zoonoses was delivered next. The International Health Regulations (IHR) is a global legal instrument which aims to prevent, protect against, control, and provide a public health response to the international spread of disease. The IHR requires rapid notification (within 24 hours of occurrence of any potential public health emergency of international concern (PHEIC), and WHO also has the right to use other sources to obtain information on an emergency of such a kind. A report on the status of zoonoses in the South-East Asia (SEA) Region of WHO was presented. Zoonotic diseases prevalent in the SEA Region can be grouped into three categories: endemic, re-emerging, and emerging disease with epidemic potential. Avian influenza (AI) A/H5N1 outbreaks have been reported since 2003 and are still continuing in many countries of the Region. The major challenge in AI control is to reduce human exposure to H5N1 virus and bring down the case fatality rate. An overview of Nipah virus, rabies, Japanese encephalitis and leptospirosis was presented. A major focus has been given to avian influenza preparedness by donors and national authorities. Other zoonotic diseases, on the other hand, have been relatively neglected. A presentation was made on zoonoses control in India. This highlighted the importance of zoonotic diseases in the context of emerging Page viii Executive summary infectious diseases and
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